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Table 5 Criteria to differentiate ADEM from MS (from ref. [29] modified)

From: Pediatric versus adult MS: similar or different?

Typical features ADEM MS
Demographic More frequent in young subjects (<10–12 years); no gender predilection More frequent in adolescents;
girls more affected than boys
Prior flu-like illness Very frequent Variable
 ▪ Seizures Variable Rare
 ▪ Encephalopathy Required in definition Rare early in the disease
 ▪ Discrete event A single event can fluctuate over the course of 12 weeks Discrete events separated by at least 4 weeks
 ▪ Large lesions involving gray and white matter Frequent Rare
 ▪ Enhancement Frequent Frequent
 ▪ Longitudinal MRI findings Lesions typically either resolve or show only residual findings Typically associated with development of new lesions
 ▪ Pleocytosis Variable rare, white blood cell count almost always < 50
 ▪ Oligoclonal bands Variable Frequent